Kostis et al identified risk factors associated with angioedema in a patient treated with the ACE inhibitor enalapril. These can help identify a patient who may benefit from preventive measures. The authors are from the University of Medicine and Dentistry of New Jersey, Creighton University, University of South Carolina and the Allergy Research Foundation (Los Angeles).
Parameters:
(1) interval after starting therapy
(2) age of the patient
(3) race
(4) history of drug rash and/or seasonal allergy
Parameter
Finding
Points
interval since starting therapy
early after starting
0
afterwards
1
age of the patient
<= 65 years
0
> 65 years of age
1
race of the patient
Black
0
other
1
history of drug rash and/or seasonal allergy
none
0
present
1
where:
• Angioedema may occur at any time after starting enalapril.
• In the implementation I added an additional risk factor for history of angioedema to enalapril.
total number of risk factors =
= SUM(points for all of the risk factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4 (5 if include history of previous episode)
• The risk increases with the number of risk factors present. Even so, this is an uncommon side effect.
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